ATYPICALS ANTIPSYCHOTIC MEDICATIONS

Size: px
Start display at page:

Download "ATYPICALS ANTIPSYCHOTIC MEDICATIONS"

Transcription

1 The atypical antipsychotics are a class of drugs that are used to treat a number of behavioral health disorders, including schizophrenia, other psychotic disorders, mood disorders, and behavioral agitation in children with autism. There is also some off label uses which include the treatment of agitation in dementia and sleep disturbances seen in a variety of mental health disorders. This class of medications offers several treatment advantages, but they are not without risk. As always, a risk-benefit analysis should be done with your patients to determine the most clinically appropriate course of action. The information, which follows, provides a brief overview of the atypicals and factors to consider when determining the most appropriate treatment for your patients. It is not meant to be fully inclusive, and supporting information should be utilized if necessary. There are currently 10 different atypical antipsychotics on the market. Many of the atypicals now have a generic equivalent. Four of the atypicals have a long acting injection as well. None of the second generation long acting agents have a generic equivalent. All of the atypicals target the blockade of D2 receptors. An additional range of binding activity at other receptor sites may account for different adverse effects seen between each medication in this class. The first generation antipsychotic medications are effective but also problematic due to the high incidence of extrapyramidal symptoms and other adverse effects such as hyperprolactinemia. In the CATIE trial (Clinical Antipsychotic Trials of Intervention Effectiveness), it was determined that the atypical medications were not more effective than the typical antipsychotic perphenazine. It should also be noted that the atypicals are not without risk for weight gain, high cholesterol and diabetes. COMPARISON OF ATYPICAL ANTIPSYCHOTICS GENERIC (BRAND)/ COST FDA-APPROVED INDICATIONS AND USUAL OR TARGET ADULT DAILY DOSE METABOLIC WEIGHT GAIN ADVERSE DIABETES RISK EVENTS DYSLIPIDEMIA QT PROLONGATION CYP3A4 METABOLISM SEDATION A,19 Schizophrenia: mg Aripiprazole (Abilifytk,L 10 mg $ Bipolar disorder (acute manic or mixed episodes; maintenance): 15 mg Depression (adjunct): 5-10 mg Low to none None None Yes Yes Low Asenapine (Saphris)m 20mg $ Schizophrenia: 10 mg (acute), 20 mg (maintenance) Bipolar disorder (acute manic or mixed episodes): mg Low to none Low to none Low to none Yes d Yes (minor) Low to Moderate For sublingual use. A void food or 1

2 GENERIC (BRAND)/ COST FDA-APPROVED INDICATIONS AND USUAL OR TARGET ADULT DAILY DOSE drink for 10 min. after administration. METABOLIC WEIGHT GAIN ADVERSE DIABETES RISK EVENTS DYSLIPIDEMIA QT PROLONGATION CYP3A4 METABOLISM SEDATION A,19 Clozapine (Clozaril, generics) 300 mg $ Schizol2hrenia (treatment-resistant): mg Recurrent suicidal behavior risk reduction in schizol2hrenia & schizoaffective disorder: mg High High High Yes Yes High Iloperidone (Fanapt) 12 mg $ Schizol2hrenia: mg Moderate Low Low Yes c Yes Low Lurasidone (Latuda) 40mg $ Schizol2hrenia: mg Take with food. Low Low Low or none No Yes Moderate Schizol2hrenia: mg Olanzapine (Zyprexa, generics ) f,k 10 mg $15.75 Bipolar disorder (acute manic or mixed episodes; maintenance): 5-20 mg Depression (associated with bipolar disorder), with fluoxetine: mg High High High Yes No Moderate Depression (treatment-resistant), with fluoxetine: 5-20 mg Paliperidone (Invega)g 6mg $ Schizol2hrenia: 3-12 mg Schizoaffective disorder (acute): 3-12 mg Low Low None Yes Yes (minor) Low 2

3 GENERIC (BRAND)/ COST FDA-APPROVED INDICATIONS AND USUAL OR TARGET ADULT DAILY DOSE METABOLIC WEIGHT GAIN ADVERSE DIABETES RISK EVENTS DYSLIPIDEMIA QT PROLONGATION CYP3A4 METABOLISM SEDATION A,19 Quetiapine (Seroquel, generics) 400mg $32.46 Schizophrenia: mg Bipolar disorder (acute depression): 300mg Bipolar disorder (acute mania, maintenance [adjunct]): mg Schizophrenia: mg Quetiapine (Seroquel XR) 400mg $ Bipolar disorder (acute depression): 300 mg Bipolar disorder (manic or mixed episodes; maintenance [adjunct]): mg Major depressive disorder [adjunct]: mg Take without food or with a light meal (about 300 kcal). Moderate Moderate Moderate Yes d Yes Moderate Risperidone (Risperdal, generics) h.k,l 4mg $1l.22 Schizophrenia: 4-8 mg Bipolar disorder (acute manic or mixed episodes): 1-6 mg Moderate Moderate Low Yes No Low 3

4 DRUG-DRUG INTERACT IONS INVOLVING ANTIPSYCHOTIC MEDICATIONS Increased psychotic levels Decreased antipsychotic levels Inhibitors of P450 la2,206, 3A4 including fluoxetine, paroxetine, fluvoxamine, nefazodone, bupropion, duloxetine, flouroquinolones and macrolide antibiotics, antifungals Beta-blockers (lipophilic), carbamazepine, Phenobarbital, phenytoin, rifampin Interference with antipsychotic Antacids (aluminum, magnesium) drug absorption Prolonged cardiac conduction Calcium channel blockers, TCAs, inhibitors of P450 isoenzyme activity (cf. above) Hypotension Antihypertensives, MAO Is, TCAs, trazadone, vasodilators Anticholinergic toxicity TCAs, benztropine, diphenydramine, mirtazapine Interference with dopaminergic effects Bromocriptine, L-dopa, pramipexole, ropinirole Additive risk of myelosuppression (clozapine) Carbamazepine, AZT ADVANTAGES OF THE ATYPICAL VERSUS THE TYPICAL ANTIPSYCHOTICS Wider range of indications Improve both positive and negative symptoms of schizophrenia Smaller risk of extrapyramidal symptoms Smaller risk of Tardive dyskinesia DISADVANTAGES OF THE ATYPICAL ANTIPSYCHOTICS VERSUS THE TYPICAL ANTIPSYCHOTICS Cost Increased risk of metabolic syndrome Increased risk of diabetes/hyperglycemia Increased risk of hyperlipidemia 4

5 OTHER FACTORS TO CONSIDER Risperidone, Olanzapine, Quetiapine, Clozapine as well as some of the typicals can cause significant weight gain. Any patient who is placed on an atypical antipsychotic needs to be monitored on the following parameters BMI, fasting blood glucose, cholesterol and triglycerides. Those patients on Geodon should have a baseline EKG, secondary to the risk of QT prolongation. It should be avoided with other medications which can prolong the QT interval. Patients on Seroquel should have baseline and 6 month slit lamp examinations for the development of cataracts. Clozapine increases the risk for seizure as well as the risk for agranulocytosis. Iloperidone should be avoided in those with hepatic impairment. The use of the atypicals in the management of psychosis and agitation in the elderly with dementia is not FDA approved and carries an increased risk of cerebrovascular events. None of the atypicals are FDA approved for the treatment of insomnia. 5

6 Bibliography Sadock, Benjamin and Virginia, Synopsis in Psychiatry, Lippincott Williams & Wilkins ninth edition 2003 Stern, Theodor and Herman, John, Massachusetts General Hospital Psychiatry Update and Board Preparation, McGraw-Hill, second edition Pharmacist s letter/prescriber s Letter, Comparison of Atypical Antipsychotics, October 2012, Older Medication Just as Effective as Newer Medication for Patients with Schizophrenia, Zacher, Jennifer and Holmes, Jamie Second-generation antipsychotics: A review of recently-approved agents and drugs in the pipeline, journal.modernmedicine.com/formulary-journal/news/clinical/clilnical-pharmacists 6

I. The Positive Symptoms...Page 2. The Negative Symptoms...Page 2. Primary Psychiatric Conditions...Page 2

I. The Positive Symptoms...Page 2. The Negative Symptoms...Page 2. Primary Psychiatric Conditions...Page 2 SUTTER PHYSICIANS ALLIANCE (SPA) 2800 L Street, 7 th Floor Sacramento, CA 95816 SPA PCP Treatment & Referral Guideline Assessment & Treatment of Psychosis Developed March 1, 2003 Revised September 21,

More information

PSYCHOPHARMACOLOGY AND WORKING WITH PSYCHIATRY PROVIDERS. Juanaelena Garcia, MD Psychiatry Director Institute for Family Health

PSYCHOPHARMACOLOGY AND WORKING WITH PSYCHIATRY PROVIDERS. Juanaelena Garcia, MD Psychiatry Director Institute for Family Health PSYCHOPHARMACOLOGY AND WORKING WITH PSYCHIATRY PROVIDERS Juanaelena Garcia, MD Psychiatry Director Institute for Family Health Learning Objectives Learn basics about the various types of medications that

More information

State of Louisiana. Department of Health and Hospitals Bureau of Health Services Financing

State of Louisiana. Department of Health and Hospitals Bureau of Health Services Financing Bobby Jindal GOVERNOR State of Louisiana Department of Health and Hospitals Bureau of Health Services Financing Kathy H. Kliebert SECRETARY The purpose of this memo is to advise you that effective September

More information

Below, this letter outlines [patient name] s medical history, prognosis, and treatment rationale.

Below, this letter outlines [patient name] s medical history, prognosis, and treatment rationale. [Date] [Name of Contact] [Title] [Name of Health Insurance Company] [Address] [City, State, Zip Code] Insured: [Patient Name] Policy Number: [Number] Group Number: [Number] Diagnosis: [Diagnosis and ICD-9-CM

More information

Psychotic Disorder. Psychosis. Psychoses may be caused by: Examples of Hallucinations and Delusions 12/12/2012

Psychotic Disorder. Psychosis. Psychoses may be caused by: Examples of Hallucinations and Delusions 12/12/2012 Psychosis Psychotic Disorder Dr Lim Boon Leng Psychiatrist and Medical Director Dr BL Lim Centre For Psychological Wellness Tel: 64796456 Email: info@psywellness.com.sg Web: www.psywellness.com.sg A condition

More information

Bipolar Disorder. Mania is the word that describes the activated phase of bipolar disorder. The symptoms of mania may include:

Bipolar Disorder. Mania is the word that describes the activated phase of bipolar disorder. The symptoms of mania may include: Bipolar Disorder What is bipolar disorder? Bipolar disorder, or manic depression, is a medical illness that causes extreme shifts in mood, energy, and functioning. These changes may be subtle or dramatic

More information

GUIDELINES FOR THE USE OF ATYPICAL ANTIPSYCHOTICS IN ADULTS. January 2012. 1 P a g e

GUIDELINES FOR THE USE OF ATYPICAL ANTIPSYCHOTICS IN ADULTS. January 2012. 1 P a g e GUIDELINES FOR THE USE OF ATYPICAL ANTIPSYCHOTICS IN ADULTS January 2012 1 P a g e First episode of psychosis or chronic psychosis First line: (equivalent choices, trial for 6 to 10 weeks) a) Risperidone

More information

Emergency Room Treatment of Psychosis

Emergency Room Treatment of Psychosis OVERVIEW The term Lewy body dementias (LBD) represents two clinical entities dementia with Lewy bodies (DLB) and Parkinson s disease dementia (PDD). While the temporal sequence of symptoms is different

More information

Understanding Antipsychotic Medications

Understanding Antipsychotic Medications Understanding Antipsychotic Medications NARSAD RESEARCH National Alliance for Research on Schizophrenia and Depression 60 Cutter Mill Road, Suite 404 Great Neck, NY 11021 516-829-0091 1-800-829-8289 516-487-6930

More information

Medications for bipolar disorder

Medications for bipolar disorder Medications for bipolar disorder Findings from Australian National Survey of Mental Health and Wellbeing (Mitchell et al, 2004) In 12 months, only one-third saw a mental health professional 40% received

More information

Chapter 18 Drugs Used for Psychoses Learning Objectives Identify signs and symptoms of psychotic behavior Describe major indications for the use of

Chapter 18 Drugs Used for Psychoses Learning Objectives Identify signs and symptoms of psychotic behavior Describe major indications for the use of Chapter 18 Drugs Used for Psychoses Learning Objectives Identify signs and symptoms of psychotic behavior Describe major indications for the use of antipsychotic agents Identify common adverse effects

More information

1/23/2014 TOPICS PHARMACOLOGY: UPDATES AND REVIEW. Elizabeth Reeve MD HealthPartners Medical Group Gillette Children s Specialty Heath Care

1/23/2014 TOPICS PHARMACOLOGY: UPDATES AND REVIEW. Elizabeth Reeve MD HealthPartners Medical Group Gillette Children s Specialty Heath Care PHARMACOLOGY: UPDATES AND REVIEW Elizabeth Reeve MD HealthPartners Medical Group Gillette Children s Specialty Heath Care TOPICS General pharmacology concepts when prescribing for children and adults When

More information

Overview of Mental Health Medication Trends

Overview of Mental Health Medication Trends America s State of Mind Report is a Medco Health Solutions, Inc. analysis examining trends in the utilization of mental health related medications among the insured population. The research reviewed prescription

More information

Medications Used in the Management of Disruptive Behavior Disorders

Medications Used in the Management of Disruptive Behavior Disorders The following medication chart is provided as a brief guide to some of the medications used in the management of various behavior disorders, along with their potential benefits and possible side effects.

More information

Conjoint Professor Brian Draper

Conjoint Professor Brian Draper Chronic Serious Mental Illness and Dementia Optimising Quality Care Psychiatry Conjoint Professor Brian Draper Academic Dept. for Old Age Psychiatry, Prince of Wales Hospital, Randwick Cognitive Course

More information

Medication Guide LATUDA (luh-too-duh) (lurasidone hydrochloride) Tablets

Medication Guide LATUDA (luh-too-duh) (lurasidone hydrochloride) Tablets Medication Guide LATUDA (luh-too-duh) (lurasidone hydrochloride) Tablets What is the most important information I should know about LATUDA? LATUDA may cause serious side effects, including: 1. Increased

More information

Chronic mental illness in LTCF. Chronic mental illness. Other psychiatric disorders.

Chronic mental illness in LTCF. Chronic mental illness. Other psychiatric disorders. Chronic mental illness in LTCF Abhilash K. Desai MD Medical Director Alzheimer s Center of Excellence Chronic mental illness 1. Schizophrenia and Schizoaffective disorder. 2. Bipolar disorder (Type 1 and

More information

New Treatments. For Bipolar Disorder. Po W. Wang, MD Clinical Associate Professor Bipolar Disorders Clinic Stanford University School of Medicine

New Treatments. For Bipolar Disorder. Po W. Wang, MD Clinical Associate Professor Bipolar Disorders Clinic Stanford University School of Medicine New Treatments For Bipolar Disorder Po W. Wang, MD Clinical Associate Professor Bipolar Disorders Clinic Stanford University School of Medicine Abbott Laboratories AstraZeneca Bristol-Myers Squibb Corcept

More information

BIPOLAR DISORDER A GUIDE FOR INDIVIDUALS AND FAMILIES FOR THE TREATMENT OF BIPOLAR DISORDER IN ADULTS

BIPOLAR DISORDER A GUIDE FOR INDIVIDUALS AND FAMILIES FOR THE TREATMENT OF BIPOLAR DISORDER IN ADULTS BIPOLAR DISORDER A GUIDE FOR INDIVIDUALS AND FAMILIES FOR THE TREATMENT OF BIPOLAR DISORDER IN ADULTS A publication of the Massachusetts Department of Mental Health and the Massachusetts Division of Medical

More information

Welcome to Who Wants to be an APNA Millionaire!

Welcome to Who Wants to be an APNA Millionaire! Welcome to Who Wants to be an APNA Millionaire! Drug-Drinks Interactions Drug-Drug Interactions Mary Gutierrez, PharmD, BCPP Clinical Professor of Pharmacy Practice (Psychiatry) Chapman University, School

More information

MEDGUIDE SECTION. What is the most important information I should know about SEROQUEL? SEROQUEL may cause serious side effects, including:

MEDGUIDE SECTION. What is the most important information I should know about SEROQUEL? SEROQUEL may cause serious side effects, including: MEDGUIDE SECTION Medication Guide SEROQUEL (SER-oh-kwell) (quetiapine fumarate) Tablets Read this Medication Guide before you start taking SEROQUEL and each time you get a refill. There may be new information.

More information

A Manic Episode is defined by a distinct period during which there is an abnormally and persistently elevated, expansive, or irritable mood.

A Manic Episode is defined by a distinct period during which there is an abnormally and persistently elevated, expansive, or irritable mood. Bipolar disorder Bipolar (manic-depressive illness) is a recurrent mode disorder. The patient may feel stable at baseline level but experience recurrent shifts to an emotional high (mania or hypomania)

More information

Antipsychotic drugs are the cornerstone of treatment

Antipsychotic drugs are the cornerstone of treatment Article Effectiveness of Olanzapine, Quetiapine, Risperidone, and Ziprasidone in Patients With Chronic Schizophrenia Following Discontinuation of a Previous Atypical Antipsychotic T. Scott Stroup, M.D.,

More information

Administer a quarter of usual dose Strong CYP2D6 or CYP3A4 inhibitors Administer half of usual dose Strong CYP2D6 and CYP3A4 inhibitors

Administer a quarter of usual dose Strong CYP2D6 or CYP3A4 inhibitors Administer half of usual dose Strong CYP2D6 and CYP3A4 inhibitors HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use ABILIFY safely and effectively. See full prescribing information for ABILIFY ABILIFY (aripiprazole)

More information

Antipsychotics and the Nursing Home

Antipsychotics and the Nursing Home Antipsychotics and the Nursing Home Lisa M. O Hara, PharmD, CGP Corporate Director of Clinical Services The State Operations Manual Part 1: F329 Unnecessary Drugs Medication Management Defined Helps promote

More information

Contemporary Psychiatric-Mental Health Nursing. Assessing the Effectiveness of Medications. Administering Medications

Contemporary Psychiatric-Mental Health Nursing. Assessing the Effectiveness of Medications. Administering Medications Contemporary Psychiatric-Mental Health Nursing Chapter 32 Psychopharmacologic Nursing Interventions Assessing the Effectiveness of Medications Include how well the medications are helping the client to

More information

3 DOSAGE FORMS AND STRENGTHS

3 DOSAGE FORMS AND STRENGTHS HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use safely and effectively. See full prescribing information for. (lurasidone hydrochloride) tablets,

More information

Medication Side Effects:

Medication Side Effects: Medication Side Effects: Staying Healthy While on Psychotropic Medications Megan Maroney PharmD, BCPP Clinical Assistant Professor Ernest Mario School of Pharmacy Rutgers the State University of New Jersey

More information

BIPOLAR DISORDER BIPOLAR I DISORDER 4/4/14

BIPOLAR DISORDER BIPOLAR I DISORDER 4/4/14 BIPOLAR DISORDER Jason Tentinger PA-C 1. Bipolar I Disorder 2. Bipolar II Disorder 3. Bipolar vs Unipolar Depression 4. Cyclothymic Disorder 5. Treatment Epidemiology BIPOLAR I DISORDER Affects around

More information

Carol Childers Director Teva Neuroscience, Inc. 901 East 104 th Street, Suite 900 Kansas City, MO 64131. RE: ANDA 076809 Clozapine tablets USP MA# 44

Carol Childers Director Teva Neuroscience, Inc. 901 East 104 th Street, Suite 900 Kansas City, MO 64131. RE: ANDA 076809 Clozapine tablets USP MA# 44 DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service Food and Drug Administration Silver Spring, MD 20993 Carol Childers Director Teva Neuroscience, Inc. 901 East 104 th Street, Suite 900 Kansas

More information

journal of medicine The new england Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia abstract

journal of medicine The new england Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia abstract The new england journal of medicine established in 1812 september 22, 2005 vol. 353 no. 12 Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia Jeffrey A. Lieberman, M.D., T. Scott

More information

Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease

Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease Antipsychotic Medications and the Risk of Diabetes and Cardiovascular Disease Professional Tool #1: Screening and Monitoring in a High-Risk Population: Questions and Answers Overview of Cardiometabolic

More information

Summary of the risk management plan (RMP) for Aripiprazole Pharmathen (aripiprazole)

Summary of the risk management plan (RMP) for Aripiprazole Pharmathen (aripiprazole) EMA/303592/2015 Summary of the risk management plan (RMP) for Aripiprazole Pharmathen (aripiprazole) This is a summary of the risk management plan (RMP) for Aripiprazole Pharmathen, which details the measures

More information

SECOND-GENERATION ANTIPSYCHOTIC DRUG USE AMONG MEDICAID-ENROLLED CHILDREN: QUALITY-OF-CARE CONCERNS

SECOND-GENERATION ANTIPSYCHOTIC DRUG USE AMONG MEDICAID-ENROLLED CHILDREN: QUALITY-OF-CARE CONCERNS Department of Health and Human Services OFFICE OF INSPECTOR GENERAL SECOND-GENERATION ANTIPSYCHOTIC DRUG USE AMONG MEDICAID-ENROLLED CHILDREN: QUALITY-OF-CARE CONCERNS Daniel R. Levinson Inspector General

More information

o DOSAGE AND ADMINISTRATION Dosage in Special Populations: The recommended initial dose is 0.5 mg BID in patients who are elderly

o DOSAGE AND ADMINISTRATION Dosage in Special Populations: The recommended initial dose is 0.5 mg BID in patients who are elderly Some critics of Janssen, including plaintiff s lawyers, have stated it is improper for Risperdal to have been used to treat elderly dementia patients. As you consider that position, we suggest you consider

More information

Shared Care Protocol for Atypical Antipsychotics

Shared Care Protocol for Atypical Antipsychotics Shared Care Protocol for Atypical Antipsychotics Version Number: 2 Name of originator/author: Chief Pharmacist, 07813 783165 (with thanks to GMW) Name of responsible committee: Clinical Governance Committee

More information

Using Antipsychotics to Treat: Depression. Comparing Effectiveness, Safety, and Price

Using Antipsychotics to Treat: Depression. Comparing Effectiveness, Safety, and Price Using Antipsychotics to Treat: Depression Comparing Effectiveness, Safety, and Price Our Recommendations Although antipsychotics were developed to treat schizophrenia, newer ones are sometimes used to

More information

HIV Case Conference: Use of Anti Psychotics for Non Psychotic Disorders

HIV Case Conference: Use of Anti Psychotics for Non Psychotic Disorders AM1 F/C AETC Faculty Psych Thursday, June 19, 2014 12:30 1:30pm (EDT) Facilitator Debbie Cestaro Seifer, MS, RN University of South Florida Didactic Presenter Patrick Marsh, MD University of South Florida

More information

Behavior and Developmental Disorders, Bipolar Disorder, and Schizophrenia Comparing safety and effectiveness

Behavior and Developmental Disorders, Bipolar Disorder, and Schizophrenia Comparing safety and effectiveness Use of Antipsychotic Medication in Children and Teens to Treat: Behavior and Developmental Disorders, Bipolar Disorder, and Schizophrenia Comparing safety and effectiveness Contents Our Recommendations.......................................

More information

These guidelines are intended to support General Practitioners in the care of their patients with dementia both in the community and in care homes.

These guidelines are intended to support General Practitioners in the care of their patients with dementia both in the community and in care homes. This is a new guideline. These guidelines are intended to support General Practitioners in the care of their patients with dementia both in the community and in care homes. It incorporates NICE clinical

More information

North of Tyne Area Prescribing Committee

North of Tyne Area Prescribing Committee North of Tyne Area Prescribing Committee ANTIPSYCHOTICS IN PSYCHOSIS, BIPOLAR DISORDER AND AUGMENTATION THERAPY IN TREATMENT RESISTANT DEPRESSION Information for Primary Care Updated November 2013 This

More information

CLINICAL PRACTICE GUIDELINES Treatment of Schizophrenia

CLINICAL PRACTICE GUIDELINES Treatment of Schizophrenia CLINICAL PRACTICE GUIDELINES Treatment of Schizophrenia III. Pharmacotherapy Medications These guidelines only refer to medications available in Canada at the time of writing. They refer to clozapine,

More information

VI.2 Elements for a Public Summary

VI.2 Elements for a Public Summary VI.2 Elements for a Public Summary VI.2.1 Overview of disease epidemiology Bipolar I Disorder Reported prevalence rates for bipolar I disorder differ due to local variations in psychiatric practice, variations

More information

Clinical Summary of Pediatric Metabolic AERS Reports. Judith Cope, MD, MPH Office of Pediatric Therapeutics/FDA

Clinical Summary of Pediatric Metabolic AERS Reports. Judith Cope, MD, MPH Office of Pediatric Therapeutics/FDA Clinical Summary of Pediatric Metabolic AERS Reports Judith Cope, MD, MPH Office of Pediatric Therapeutics/FDA 1 Clinical Summary of Pediatric Metabolic AERS Reports: Atypical Antipsychotics n=100 reports;

More information

Objectives. The use of Psychotropics in Children

Objectives. The use of Psychotropics in Children Objectives The use of Psychotropics in Children Ashley E. Little, Pharm.D. Psychopharmacology Resident Nova Southeastern University College of Pharmacy Dade County Pharmacy Association To understand current

More information

SAVE UP TO on each of your next 12 prescriptions. (after you pay the first $25)* 2015_08_14_SAPHRIS_copay_card_for_download_KH_v8.

SAVE UP TO on each of your next 12 prescriptions. (after you pay the first $25)* 2015_08_14_SAPHRIS_copay_card_for_download_KH_v8. START SAVING TODAY WITH RESTRICTIONS APPLY SAVINGS PROGRAM SAVINGS PROGRAM SAVE UP TO on each of your next 12 prescriptions (after you pay the first $25)* $ 100 BIN# 004682 PCN# CN GRP# EC48010004 ID#

More information

2. The prescribing clinician will register with the designated manufacturer.

2. The prescribing clinician will register with the designated manufacturer. Clozapine Management Program Description Magellan of Arizona Pharmacy Program Background: Magellan Health Services of Arizona recognizes the importance of a clozapine program. Clozapine received increased

More information

TREATING MAJOR DEPRESSIVE DISORDER

TREATING MAJOR DEPRESSIVE DISORDER TREATING MAJOR DEPRESSIVE DISORDER A Quick Reference Guide Based on Practice Guideline for the Treatment of Patients With Major Depressive Disorder, Second Edition, originally published in April 2000.

More information

--------------------------- RECENT MAJOR CHANGES -------------------------Warnings and Precautions:

--------------------------- RECENT MAJOR CHANGES -------------------------Warnings and Precautions: HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use safely and effectively. See full prescribing information for. (olanzapine and fluoxetine) capsules

More information

Page 1 of 73. Initial Recommended Maximum Dose Dose Dose. 30 mg. /day. /day. /day. 2 mg. Schizophrenia adults (2.1) 10 mg. /day. /day. /day.

Page 1 of 73. Initial Recommended Maximum Dose Dose Dose. 30 mg. /day. /day. /day. 2 mg. Schizophrenia adults (2.1) 10 mg. /day. /day. /day. HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use ABILIFY safely and effectively. See full prescribing information for ABILIFY. ABILIFY (aripiprazole)

More information

A few general principles regarding medications are important to consider before initiating therapy in individuals diagnosed with a dementia

A few general principles regarding medications are important to consider before initiating therapy in individuals diagnosed with a dementia MEDICATIONS USED FOR THE MANAGEMENT OF DEMENTIA AND RELATED BEHAVIORIAL COMPLICATIONS* R.Ron Finley, B.S Pharm, R.Ph,CGP, Aimee Loucks, Pharm. D., Gil D. Rabinovici, M.D The following is intended to be

More information

DIABETES SCREENING FOR PEOPLE WITH SCHIZOPHRENIA OR BIPOLAR DISORDER WHO ARE USING ANTIPSYCHOTIC MEDICATIONS (SSD)

DIABETES SCREENING FOR PEOPLE WITH SCHIZOPHRENIA OR BIPOLAR DISORDER WHO ARE USING ANTIPSYCHOTIC MEDICATIONS (SSD) DIABETES SCREENING FOR PEOPLE WITH SCHIZOPHRENIA OR BIPOLAR DISORDER WHO ARE USING ANTIPSYCHOTIC MEDICATIONS (SSD) APPLICATIONS OBJECTIVE Purpose of Measure: ELIGIBLE POPULATION Which members are included?

More information

Antipsychotic medications in primary care:

Antipsychotic medications in primary care: Balanced information for better care Antipsychotic medications in primary care: Limited benefit, sizable risk Antipsychotic medications in primary care: Limited benefit, sizeable risk Author: Danielle

More information

Asenapine (Saphris) for bipolar I disorder

Asenapine (Saphris) for bipolar I disorder Asenapine (Saphris) for bipolar I disorder This Medicine Update is for people with bipolar I disorder who are taking, or thinking about taking, asenapine. Summary Asenapine is an antipsychotic medicine.

More information

Preventing overuse of antipsychotic drugs in nursing home care

Preventing overuse of antipsychotic drugs in nursing home care Balanced information for better care Preventing overuse of antipsychotic drugs in nursing home care Safer alternatives Preventing overuse of antipsychotic drugs in nursing home care Safer alternatives

More information

PSYCHOTROPIC MEDICATIONS

PSYCHOTROPIC MEDICATIONS PSYCHOTROPIC MEDICATIONS 644.3 Bipolar Disorder This Instructor s Guide contains: Brief Description, Objectives, Discussion Questions, Pretest, Post-test, Answer Keys and Glossary for this program, Psychotropic

More information

Medications for Huntington s Disease Vicki Wheelock, M.D.

Medications for Huntington s Disease Vicki Wheelock, M.D. Medications for Huntington s Disease Vicki Wheelock, M.D. Director, HDSA Center of Excellence at UC Davis June 4, 2013 Outline Introduction and disclaimers Medications for cognitive symptoms Medications

More information

PL CE LIVE December 2011 Long Guide

PL CE LIVE December 2011 Long Guide This handout accompanies the related articles published in December 2011 ~ Volume 27 ~ Number 12 following PL CE LIVE December 2011 Long Guide CARDIOLOGY You ll start hearing lots more about the comparisons

More information

A GUIDE TO THE MANAGEMENT OF PSYCHOTIC DISORDERS AND NEUROPSYCHIATRIC SYMPTOMS OF DEMENTIA IN OLDER ADULTS From THE AMERICAN GERIATRICS SOCIETY

A GUIDE TO THE MANAGEMENT OF PSYCHOTIC DISORDERS AND NEUROPSYCHIATRIC SYMPTOMS OF DEMENTIA IN OLDER ADULTS From THE AMERICAN GERIATRICS SOCIETY A GUIDE TO THE MANAGEMENT OF PSYCHOTIC DISORDERS AND NEUROPSYCHIATRIC SYMPTOMS OF DEMENTIA IN OLDER ADULTS From THE AMERICAN GERIATRICS SOCIETY ThisguidewasreviewedbyapanelofAGSmembersrepresentinggeriatricmedicine,geropsychiatry,andgeriatricpharmacy.The

More information

COMPREHENSIVE MANAGEMENT OF THE ELDERLY PATIENT WITH MANIA

COMPREHENSIVE MANAGEMENT OF THE ELDERLY PATIENT WITH MANIA COMPREHENSIVE MANAGEMENT OF THE ELDERLY PATIENT WITH MANIA Manic depressive illness is a biological brain disorder that produces significant alterations of mood and psychosis. Mania in the elderly occurs

More information

Clinical Recommendations for Treatment of Bipolar Disorder for Hong Kong 2013

Clinical Recommendations for Treatment of Bipolar Disorder for Hong Kong 2013 Clinical Recommendations for Treatment of Bipolar Disorder for Hong Kong 2013 Version: March 2013 Objectives of Treatment Rapid control of symptoms especially agitation, impulsivity, aggression, suicidality

More information

Olanzapine Elderly Dementia

Olanzapine Elderly Dementia Olanzapine Elderly Dementia olanzapine journal articles olanzapine generic name olanzapine recreational olanzapine used for anorexia olanzapine usp olanzapine liquid olanzapine jubilant olanzapine how

More information

Depression Flow Chart

Depression Flow Chart Depression Flow Chart SCREEN FOR DEPRESSION ANNUALLY Assess for depression annually with the PHQ-9. Maintain a high index of suspicion in high risk older adults. Consider suicide risk and contributing

More information

Reimbursement and Billing Guide

Reimbursement and Billing Guide Reimbursement and Billing Guide Disclaimer This document is presented for informational purposes only and is not intended to provide reimbursement or legal advice, nor does it promise or guarantee coverage,

More information

Olanzapine Maximum Dose

Olanzapine Maximum Dose Olanzapine Maximum Dose olanzapine breastfeeding olanzapine hyponatremia olanzapine blood sugar olanzapine class olanzapine long acting olanzapine for delirium olanzapine jubilant 10 mg olanzapine tab

More information

Olanzapine Generic Availability

Olanzapine Generic Availability Olanzapine Generic Availability olanzapine msds olanzapine kills olanzapine grapefruit juice olanzapine neuroleptic malignant syndrome olanzapine abuse olanzapine used for anxiety olanzapine off label

More information

Olanzapine Uses. olanzapine generic name. olanzapine uptodate. olanzapine other names. olanzapine vomiting. olanzapine leukopenia.

Olanzapine Uses. olanzapine generic name. olanzapine uptodate. olanzapine other names. olanzapine vomiting. olanzapine leukopenia. Olanzapine Uses olanzapine generic name olanzapine uptodate olanzapine other names olanzapine vomiting olanzapine leukopenia olanzapine nami olanzapine high abuse olanzapine medication olanzapine grapefruit

More information

Olanzapine Dosage Forms

Olanzapine Dosage Forms Olanzapine Dosage Forms olanzapine rash olanzapine history olanzapine ingredients olanzapine ketoacidosis olanzapine msds olanzapine narcotic olanzapine classification olanzapine geriatric olanzapine chemical

More information

Olanzapine Kidney Damage

Olanzapine Kidney Damage Olanzapine Kidney Damage 1 olanzapine generic price 2 olanzapine ocd 3 olanzapine uk 4 olanzapine grapefruit juice 5 olanzapine contraindications 6 olanzapine manufacturer 7 olanzapine drug test 8 olanzapine

More information

Olanzapine Renal Dosing

Olanzapine Renal Dosing Olanzapine Renal Dosing olanzapine uses olanzapine binge eating olanzapine fluoxetine olanzapine benzo olanzapine other names olanzapine generic availability olanzapine generic name olanzapine adverse

More information

Olanzapine Uptodate olanzapine make you gain weight olanzapine structure olanzapine st john's wort

Olanzapine Uptodate olanzapine make you gain weight olanzapine structure olanzapine st john's wort Olanzapine Uptodate olanzapine drug class olanzapine generic name olanzapine youtube olanzapine action olanzapine medscape olanzapine ingredients olanzapine make you gain weight olanzapine bluelight olanzapine

More information

olanzapine is it a narcotic olanzapine narcotic olanzapine how supplied olanzapine vomiting olanzapine jubilant 10 mg olanzapine teaching olanzapine

olanzapine is it a narcotic olanzapine narcotic olanzapine how supplied olanzapine vomiting olanzapine jubilant 10 mg olanzapine teaching olanzapine Olanzapine Kick In olanzapine nursing implications olanzapine mechanism of action olanzapine images olanzapine dosing olanzapine kick in olanzapine neuroleptic malignant syndrome olanzapine xerostomia

More information

Olanzapine Urinary Retention

Olanzapine Urinary Retention Olanzapine Urinary Retention olanzapine monitoring olanzapine joint pain olanzapine benzo olanzapine fda indications olanzapine japanese pharmacopoeia olanzapine high erowid olanzapine classification olanzapine

More information

Olanzapine Nms olanzapine narcotic olanzapine street value olanzapine japanese pharmacopoeia olanzapine pharmacokinetics olanzapine yahoo answers

Olanzapine Nms olanzapine narcotic olanzapine street value olanzapine japanese pharmacopoeia olanzapine pharmacokinetics olanzapine yahoo answers Olanzapine Nms 1 olanzapine narcotic 2 olanzapine used for sleep 3 olanzapine street value 4 olanzapine japanese pharmacopoeia 5 olanzapine zyprexa 6 olanzapine how supplied 7 olanzapine chemical structure

More information

Olanzapine Gynecomastia

Olanzapine Gynecomastia Olanzapine Gynecomastia 1 olanzapine drug 2 olanzapine black box warning 3 olanzapine nursing considerations 4 olanzapine images 5 olanzapine lab tests 6 olanzapine klonopin 7 olanzapine tab 2.5mg 8 olanzapine

More information

Olanzapine Benzo. olanzapine glaucoma. olanzapine jubilant 10 mg. olanzapine trade name. olanzapine drug class. olanzapine yahoo answers

Olanzapine Benzo. olanzapine glaucoma. olanzapine jubilant 10 mg. olanzapine trade name. olanzapine drug class. olanzapine yahoo answers Olanzapine Benzo olanzapine glaucoma olanzapine jubilant 10 mg olanzapine trade name olanzapine drug class olanzapine yahoo answers olanzapine makes you sleepy olanzapine onset of action olanzapine action

More information

olanzapine pregnancy olanzapine overdose treatment olanzapine ketoacidosis olanzapine zopiclone olanzapine odt olanzapine chemical structure

olanzapine pregnancy olanzapine overdose treatment olanzapine ketoacidosis olanzapine zopiclone olanzapine odt olanzapine chemical structure Olanzapine Xtc olanzapine oral olanzapine nursing implications olanzapine off label uses olanzapine insomnia olanzapine dosage forms olanzapine classification olanzapine interactions olanzapine kills olanzapine

More information

Olanzapine For Cinv. olanzapine schizophrenia. olanzapine ingredients. olanzapine contraindications. olanzapine adverse effects.

Olanzapine For Cinv. olanzapine schizophrenia. olanzapine ingredients. olanzapine contraindications. olanzapine adverse effects. Olanzapine For Cinv olanzapine schizophrenia olanzapine ingredients olanzapine contraindications olanzapine adverse effects olanzapine pill olanzapine nursing implications olanzapine j code olanzapine

More information

Clinical Audit: Prescribing antipsychotic medication for people with dementia

Clinical Audit: Prescribing antipsychotic medication for people with dementia Clinical Audit: Prescribing antipsychotic medication for people with dementia Trust, team and patient information Q1. Patient's DIS number... Q2. Patient s residence: Home Residential Home Nursing Home

More information

A BRIEF OVERVIEW OF PSYCHOTROPIC MEDICATION USE FOR PERSONS WITH INTELLECTUAL DISABILITIES

A BRIEF OVERVIEW OF PSYCHOTROPIC MEDICATION USE FOR PERSONS WITH INTELLECTUAL DISABILITIES INTRODUCTION A BRIEF OVERVIEW OF PSYCHOTROPIC MEDICATION USE FOR PERSONS WITH INTELLECTUAL DISABILITIES Individuals with intellectual disabilities are not uncommonly prescribed psychotropic medications.

More information

Psychopharmacotherapy for Children and Adolescents

Psychopharmacotherapy for Children and Adolescents TREATMENT GUIDELINES Psychopharmacotherapy for Children and Adolescents Guideline 7 Psychopharmacotherapy for Children and Adolescents Description There are few controlled trials to guide practitioners

More information

Olanzapine Manufacturer

Olanzapine Manufacturer Olanzapine Manufacturer olanzapine medicine olanzapine sleep olanzapine gynecomastia olanzapine kidney damage olanzapine seizure olanzapine structure olanzapine serotonin syndrome olanzapine tab 5mg olanzapine

More information

Important Safety Information about ZYPREXA RELPREVV (olanzapine) For Extended Release Injectable Suspension

Important Safety Information about ZYPREXA RELPREVV (olanzapine) For Extended Release Injectable Suspension Important Safety Information about ZYPREXA RELPREVV (olanzapine) For Extended Release Injectable Suspension Boxed Warnings Post-Injection Delirium/Sedation Syndrome Adverse events with signs and symptoms

More information

Improving the Recognition and Treatment of Bipolar Depression

Improving the Recognition and Treatment of Bipolar Depression Handout for the Neuroscience Education Institute (NEI) online activity: Improving the Recognition and Treatment of Bipolar Depression Learning Objectives Apply evidence-based tools that aid in differentiating

More information

PL CE LIVE December 2011 Forum

PL CE LIVE December 2011 Forum December 2011 PL CE LIVE Kristin W. Weitzel, Pharm.D., CDE, FAPhA Associate Editor Pharmacist s Letter/Prescriber s Letter CE Information Pharmacist's Letter / Therapeutic Research Center is accredited

More information

Treatment of Behavioral Health Disorders in Adolescents: Depression, Bipolar Disorder, Schizophrenia

Treatment of Behavioral Health Disorders in Adolescents: Depression, Bipolar Disorder, Schizophrenia Treatment of Behavioral Health Disorders in Adolescents: Depression, Bipolar Disorder, Schizophrenia ELINORE F. MCCANCE-KATZ, MD, PHD CHIEF MEDICAL OFFICER SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

More information

Olanzapine Benzo. olanzapine kidney damage. olanzapine generic name. Norvasc Pitting Edema. olanzapine elderly dementia. olanzapine contraindications

Olanzapine Benzo. olanzapine kidney damage. olanzapine generic name. Norvasc Pitting Edema. olanzapine elderly dementia. olanzapine contraindications Olanzapine Benzo olanzapine kidney damage olanzapine generic name Norvasc Pitting Edema olanzapine elderly dementia olanzapine contraindications olanzapine for anxiety olanzapine treats what olanzapine

More information

Anxiety, ADHD, Depression, Insomnia, and PTSD

Anxiety, ADHD, Depression, Insomnia, and PTSD Use of Antipsychotic Medications Off-Label to Treat: Anxiety, ADHD, Depression, Insomnia, and PTSD Evaluating Safety and Effectiveness Contents 2: Our recommendations 3: Welcome 6: What is the evidence

More information

Olanzapine Odt. olanzapine kills. olanzapine rapids. olanzapine sleep. olanzapine treats what. olanzapine neuroleptic malignant syndrome

Olanzapine Odt. olanzapine kills. olanzapine rapids. olanzapine sleep. olanzapine treats what. olanzapine neuroleptic malignant syndrome Olanzapine Odt olanzapine kills olanzapine rapids olanzapine sleep olanzapine treats what olanzapine neuroleptic malignant syndrome olanzapine nausea olanzapine eps olanzapine how supplied olanzapine formulations

More information

Olanzapine Level olanzapine pronunciation olanzapine vomiting olanzapine toxicity

Olanzapine Level olanzapine pronunciation olanzapine vomiting olanzapine toxicity Olanzapine Level 1 olanzapine nursing implications 2 olanzapine benzo 3 olanzapine joint pain 4 olanzapine generic name 5 olanzapine insomnia 6 olanzapine usp 7 olanzapine ingredients 8 olanzapine nausea

More information

Olanzapine Serotonin Syndrome

Olanzapine Serotonin Syndrome Olanzapine Serotonin Syndrome olanzapine for delirium olanzapine for cinv olanzapine generic price olanzapine relprevv olanzapine yellow olanzapine lab tests olanzapine benzodiazepine olanzapine depression

More information

Treatments for Major Depression. Drug Treatments The two (2) classes of drugs that are typical antidepressants are:

Treatments for Major Depression. Drug Treatments The two (2) classes of drugs that are typical antidepressants are: Treatments for Major Depression Drug Treatments The two (2) classes of drugs that are typical antidepressants are: 1. 2. These 2 classes of drugs increase the amount of monoamine neurotransmitters through

More information

Olanzapine Fda Indications

Olanzapine Fda Indications Olanzapine Fda Indications olanzapine eps olanzapine dosing olanzapine toxicity olanzapine epocrates olanzapine benzo olanzapine abuse olanzapine interactions olanzapine names olanzapine zombie olanzapine

More information

Clinical Guideline / Formulary Document Pharmacy Department Medicines Management Services

Clinical Guideline / Formulary Document Pharmacy Department Medicines Management Services Clinical Guideline / Formulary Document Pharmacy Department Medicines Management Services DEPRESSION Pharmacological Treatment of Depression NICE guidelines suggest the following stepped care model also

More information

Thorazine (chlorpromazine)

Thorazine (chlorpromazine) Generic name: Chlorpromazine Available strengths: 10 mg, 25 mg, 50 mg, 100 mg, 200 mg tablets; 100 mg/ml oral concentrate; 25 mg/ml injection Available in generic: Yes Drug class: First-generation (conventional)

More information

ACAMPROSATE. THERAPEUTICS Brands Campral see index for additional brand names. Tests None for healthy individuals

ACAMPROSATE. THERAPEUTICS Brands Campral see index for additional brand names. Tests None for healthy individuals ACAMPROSATE THERAPEUTICS Brands Campral see index for additional brand names Generic? Not in U.S. Class Alcohol dependence treatment Commonly Prescribed for (bold for FDA approved) Maintenance of alcohol

More information

Medication Guide. What is the most important information I should know about ZYPREXA? ZYPREXA may cause serious side effects, including:

Medication Guide. What is the most important information I should know about ZYPREXA? ZYPREXA may cause serious side effects, including: Medication Guide 1 PV 6925 AMP ZYPREXA (zy-prex-a) (olanzapine) Tablet ZYPREXA ZYDIS (zy-prex-a ZY-dis) (olanzapine) Tablet, Orally Disintegrating Read the Medication Guide that comes with ZYPREXA before

More information

ALPRAZOLAM. THERAPEUTICS Brands Xanax, Xanax XR see index for additional brand names. Generic? Yes (not for XR) Class Benzodiazepine (anxiolytic)

ALPRAZOLAM. THERAPEUTICS Brands Xanax, Xanax XR see index for additional brand names. Generic? Yes (not for XR) Class Benzodiazepine (anxiolytic) ALPRAZOLAM THERAPEUTICS Brands Xanax, Xanax XR see index for additional brand names Generic? Yes (not for XR) Class Benzodiazepine (anxiolytic) Commonly Prescribed For (bold for FDA approved) Generalized

More information

Barriers to Healthcare Services for People with Mental Disorders. Cardiovascular disorders and diabetes in people with severe mental illness

Barriers to Healthcare Services for People with Mental Disorders. Cardiovascular disorders and diabetes in people with severe mental illness Barriers to Healthcare Services for People with Mental Disorders Cardiovascular disorders and diabetes in people with severe mental illness Dr. med. J. Cordes LVR- Klinikum Düsseldorf Kliniken der Heinrich-Heine-Universität

More information

SESSION K2. When SSRIs Are Not Enough, What Then?

SESSION K2. When SSRIs Are Not Enough, What Then? 37th Annual Advanced Practice in Primary and Acute Care Conference: October 9-11, 2014 SESSION K2 3:55 When SSRIs Are Not Enough, What Then? Scott MacHaffie, MN, ARNP S E S S I O N Session Description:

More information